Long-term recurrence of venous thromboembolism after short-term treatment of symptomatic isolated distal deep vein thrombosis: A cohort study.

Isolated distal deep vein thrombosis (IDDVT) is a common clinical manifestation of venous thromboembolism (VTE). However, there are only scant and heterogeneous data available on the long-term risk of recurrent VTE after IDDVT, and the optimal therapeutic management remains uncertain. We carried out a retrospective cohort study of consecutive patients diagnosed with symptomatic IDDVT between 2004 and 2011, according to a predefined short-term treatment protocol (low molecular weight heparin (LMWH) for 4-6 weeks).

Relationship between ABO blood group and hemorrhage: a systematic literature review and meta-analysis.

Several studies have suggested that patients with non-O blood group have an increased risk of both venous and arterial thromboembolic events. On the contrary, the role of ABO blood group on the risk of bleeding complications remains unclear. Thus, we performed a meta-analysis of the literature with the aim of assessing this potential association.

New direct thrombin inhibitors.

Direct thrombin inhibitors (DTIs) are a class of anticoagulants that bind selectively to thrombin and block its interaction with its substrates. Dabigatran etexilate and AZD0837, the new generation of DTIs, are now under intense development, and are potentially of great interest for internists. Dabigatran etexilate is a potent, non-peptidic small molecule that specifically and reversibly inhibits both free and clot-bound thrombin by binding to the active site of thrombin molecule.

The embolic storm: dramatic peripheral complications of left ventricular thrombosis after myocardial infarction.

Left ventricular thrombus is a common complication after acute myocardial infarction. Although anticoagulant treatment has an established role in reducing the rate of thrombus formation and embolic phenomena during acute myocardial infarction, prior studies showed that left ventricular thrombus and systemic embolization may develop irrespective of adequate anticoagulant therapy. We present a descriptive case of a patient with left ventricular thrombus who experienced dramatic peripheral embolic events soon after the onset of anterior myocardial infarction despite full anticoagulation, and we discuss possible pathogenesis.

Traditional and non traditional risk factors in accelerated atherosclerosis in systemic lupus erythematosus: role of vascular endothelial growth factor (VEGATS Study).

Objective: To evaluate the role of vascular endothelial growth factor (VEGF) in accelerated atherosclerosis in patients with Systemic Lupus Erythematosus (SLE).

Methods: We have enrolled 80 SLE female patients and 80 age-matched healthy control females who underwent a structured interview, physical examination, routine laboratory tests, VEGF plasma level determination and B-mode ultrasonography of carotid arteries to determine carotid intima media thickness (IMT). Framingham risk factors for cardiovascular events were also calculated and VEGF plasma levels were correlated with traditional and nontraditional cardiovascular risk factors.

[Current issues in the initial phase of warfarin therapy].

Warfarin is the most commonly used vitamin K antagonist (VKA), based on its demonstrated efficacy in the prevention and treatment of venous and arterial thromboembolism. Optimal management of warfarin therapy is a daily challenge, mainly because of its complex pharmacokinetics and pharmacodynamics. In particular, the induction phase of warfarin treatment is unpredictable, thus placing patients to an increased risk of excessive anticoagulation, which predisposes to bleeding, or to prolonged subtherapeutic anticoagulation, which predisposes to thrombosis and often mandates extended therapy with parenteral anticoagulants.

Residual venous obstruction in patients with a single episode of deep vein thrombosis and in patients with recurrent deep vein thrombosis.

Residual venous obstruction (RVO) in patients with previous deep vein thrombosis (DVT) of the lower limbs has been suggested as an independent risk factor for recurrent venous thromboembolism (VTE). RVO could be a marker of a persistent prothrombotic state. We have compared the rate of RVO in patients with DVT and a personal history of at least one previous episode of VTE to the rate of RVO among patients with a first episode of DVT.

Home-treatment of deep vein thrombosis in patients with cancer.

Background And Objectives: Outpatient treatment of deep vein thrombosis (DVT) has become a common practice. However, in some centers cancer patients with DVT are excluded from home treatment because they have a higher risk of both bleeding and recurrent DVT. We performed a retrospective review of clinical practice patterns to assess the rate of cancer patients who were deemed eligible for outpatient treatment of their DVT.

Weight gain after acute deep venous thrombosis: a prospective observational study.

Introduction: The onset of acute disorders often results in a significant reduction in physical exercise, thus predisposing to further increase in body weight. Weight gain is strongly associated with an increase in metabolic and cardiovascular risk factors. The aim of this study was to assess weight changes occurring after an episode of acute deep venous thrombosis (DVT).

Body mass index is associated with the development of the post-thrombotic syndrome.

Post-thrombotic syndrome (PTS) is a chronic complication of deep vein thrombosis (DVT). Little is known about prognostic factors that might identify patients at high risk for the development of PTS. Body mass index (BMI) has been previously reported to be associated to the development of PTS.

The initial phase of oral anticoagulation with warfarin in outpatients with deep venous thrombosis.

Patients with deep venous thrombosis (DVT) treated out of hospital usually start warfarin with the recommended 5 mg loading dose and have their International Normalized Ratio (INR) test performed every 2-3 days. Thus, achievement of the therapeutic range may be more difficult than for inpatients, possibly resulting in extended duration of low molecular weight heparin (LMWH) treatment. We retrospectively examined the charts of 55 DVT outpatients (mean age, 61.

Plasma measurement of D-dimer levels for the early diagnosis of ischemic stroke subtypes.

Background: Different coagulation abnormalities according to stroke subtypes have been reported. We have assessed the clinical utility of D-dimer, a product of fibrin degradation, in the early diagnosis of stroke subtypes.

Methods: Patients hospitalized after an acute ischemic cerebrovascular event underwent D-dimer assay (STA Liatest D-Dimer) (reference level, <0.

Oral vitamin K lowers the international normalized ratio more rapidly than subcutaneous vitamin K in the treatment of warfarin-associated coagulopathy. A randomized, controlled trial.

Background: Excessive anticoagulation due to warfarin use is associated with hemorrhage. Subcutaneously administered vitamin K has not been evaluated for the treatment of warfarin-associated coagulopathy, yet it is widely used.

Objective: To show that oral vitamin K is more effective than subcutaneous vitamin K in the treatment of warfarin-associated coagulopathy.

Thrombosis prophylaxis in medical patients: a retrospective review of clinical practice patterns.

Background And Objectives: The risk of venous thromboembolism in medical patients is comparable to the risk in general surgical patients. Thromboprophylaxis is recommended for specific medical patients, but its use in clinical practice is unknown.

Design And Methods: We conducted a retrospective review of the charts of consecutive patients discharged from 2 departments of Internal Medicine, one in the teaching hospital of Varese and one in the non-teaching hospital of Angera, Italy, from October to December 2000.

Selecting patients for home treatment of deep vein thrombosis: the problem of cancer.

Background And Objectives: Patients with deep vein thrombosis are selected for home treatment on the basis of their clinical and social condition. Cancer is frequently associated with venous thromboembolism and is often considered an exclusion criterion for outpatient treatment. We investigated the impact of cancer on the outpatient management of venous thrombosis.